Yesterday, I went to a symposium at the IU-McKinney School of Law in Indianapolis. It was billed as State Governments’ Role in Bridging the Urban/Rural Divide. The symposium wasn’t that, exactly. I heard a lot about concerns in rural Indiana, not so much about concerns in urban Indiana, little about getting urban to care about rural concerns, and nothing about getting rural to care about urban concerns.

But it was good nonetheless. The first part was about limited access to justice in rural areas — mainly there just aren’t as many lawyers per person. There was a bit about the ethical challenges rural attorneys face because conflicts are easy to come by with so few people in the area. The second major part was about gerrymandering. And the third main part was a presentation by Jim McClelland, the executive director of Indiana’s Drug Treatment, Prevention, and Enforcement division. (I’ve seen him referred to as Indiana’s Drug Czar.)

He is a supporter of Indiana’s syringe exchange programs. Saying he was initially opposed or uncertain about such programs, he said in the presentation that, among other things, his daughter’s experience as a nurse helped persuade him.  This is contrary to Indiana’s Attorney General, Curtis Hill, who has been critical of such programs. From what I’ve seen anecdotally, these two are perhaps representative of the divide generally between law enforcement officials who tend to be opposed and policy-makers with more generalized responsibilities who tend to be cautiously in favor.

Opposition to the programs make intuitive sense. If you’re fighting arson, you don’t hand out cans of gasoline and matches. There’s a concern that if you give addicts needles and other paraphernalia necessary to take the opioid drugs, you’re just encouraging them, perhaps encouraging new users, and maybe making the problem worse. To those who view this as more of a health crisis than a criminal epidemic, the critique looks similar to opposition to handing out condoms for pregnancy and disease prevention on the grounds that it will promote sex.

Needles are cheaper than livers.

McClelland says that the evidence suggests that handing out needles doesn’t increase drug use. The primary utility is in reducing transmission of HIV and Hepatitis C which are hugely expensive to treat. I think he cited $400,000 per person for HIV. I don’t think he gave a number for Hepatitis C, but it isn’t cheap. He also said that, of course, needles alone aren’t a solution for reducing addiction. The utility of syringe exchanges in terms of trying to reduce the addiction problem is that it serves as a touch point with the system where you can try to get the addicts connected with medicine and counseling. McClelland gave some statistics about medicine without counseling and counseling without medicine. Neither was very good. Worse still was just trying to stop on your own. Access to the medications and qualified professionals is not very good. As he put it, “it’s easier to get high than to get help.”

There was a person in the audience who asked a question which he put in a more circumspect manner but basically suggested that, when addiction was seen as mostly a problem among minorities, it was not viewed as a health concern, but now that addiction is a problem among rural white communities, it’s viewed as less a criminal concern and more a health concern. McClelland declined to be drawn into that question, viewing his job as being to do what he can to help Indiana to mitigate this problem regardless of whether its policy approaches have been right or wrong in the past.

My exposure to Mr. McClelland was listening to him for 45 minutes, so this is not a hugely well-informed opinion, but I do get the distinct impression that Gov. Holcomb has made a good appointment for this job.

Dave Bangert, writing for the Lafayette Journal & Courier, has an article on Judge Tom Busch’s announcement that he is going to be retiring as judge for the Circuit Court of Tippecanoe County. I learned a lot of what I know about practicing law from Tom. He was a partner with the firm when I signed on as an associate. I had just become partner in January of 2002 when a position on the bench opened up upon the death of Judge Heid. I still remember eating lunch at the Triple XXX Family Restaurant when Tom told us he was going to seek the position. That moment was significant for me because I felt like it’s when the training wheels came off for me as an attorney. Our other partner, Dave Luhman, was still a strong presence at the firm, but I had mostly been doing collections and work for Tom while I was an associate. When Tom left, a lot of his case load went to me directly and I didn’t have him to lean on anymore. It was scary, but it worked out.

Tom has done a great job as a judge over the years. He was a judge you wanted looking at your case, particularly if you had a novel argument or a non-routine matter to look at. He has a great curiosity about the law. (As an associate, that could be frustrating when he sent you back for the nth revision of a brief, but it’s a good quality in a lawyer or a judge!) Back in 2014, he left his position as judge of Superior Court 2 to run for the Circuit Court position which he won. When he retires at the end of the year, Governor Holcomb will fill the position. There are three years left on Judge Busch’s term, but I think there will now be an election in November which will result in a full six year term beginning January 2019. So, Governor Holcomb’s replacement will serve for a year under the governor’s appointment.

And Judge Busch will get to see more of his family which is truly far flung at this point. He’s earned it!

The Indiana Law Blog has a post noting that LSA is having a celebration of its 50th anniversary tomorrow (March 7). Marcia was there at its founding in 1967 (and worked for its predecessor). Its creation came during a time of legislative reform generally. The agency is nonpartisan and is responsible for drafting legislation, calculating the fiscal impact of proposed legislation, and providing legislators — to the extent possible — with unbiased advice. Legislators obviously have partisan interests to serve as well, and for this, they have caucus attorneys who can and sometimes do draft legislation. But, for the most part, the bulk of the legislation is drafted by LSA. I’m biased, but I’d put the clarity and functionality of our Indiana Code up against  any state’s, and it’s far more usable and understandable than the United States Code. (As an LSA staffer, it was not my job to offer policy advice. So, I won’t – at this point – comment on the merit of the policies reflected in that Code.)

I was only there from 1996 – 1999, but the agency had a significant impact on me. Legislative drafting exercises some different muscles than the more narrative brief writing or drafting contracts (which is, stylistically,  maybe a hybrid between briefs and legislation). It forces a precision that can be helpful. (In many ways, I think legislative drafting and computer programming have a lot in common.) It gave me an interest and an insight into the legislative process which (in combination with my unpursued dream of being a newspaper columnist) morphed into this blog. And, it gave me some marketable skills that I was able to parlay into the job I have now.

Most of all, I was fortunate to work with some really great people. (My boss was kind enough to arrange to have himself appointed judge for a day so he could be the officiant when Amy and I got married.) I think the list of people who worked there when I was there is getting pretty small, but I think the culture of quiet diligence and professionalism still endures, and that’s a tremendous asset to the State.

So, from DI #93, Happy 50th Birthday to LSA!

The law gives you a little of everything. Sometimes in the same case. You don’t really expect the subject of sex to turn up in a contractual deed merger case. But you never know. (“Where two parties have made a simple contract for any purpose, and afterwards have entered into an identical engagement by deed, the simple contract is merged in the deed and becomes extinct.”)

The Indiana Court of Appeals entered an order in the case of Hemingway v. Scott (pdf) affirming a trial court decision requiring an unfaithful girlfriend to quitclaim her part of certain real estate to her former boyfriend.

In 2001, Scott inherited a ten-acre parcel of land (“the Property”) from his father. In 2004, Hemingway and Scott began a relationship, and Hemingway moved in with Scott. The couple broke up for a time, and Hemingway moved out. On February 17, 2012, the couple executed a handwritten contract, penned by Hemingway and signed by both, pursuant to which Scott promised to convey the Property from himself to himself and Hemingway. The contract included a list of conditions that would constitute a breach, including “cheating” by either party.

Scott executed a deed conveying the Property to himself and Hemingway as joint tenants. About two months later, Hemingway became pregnant by another man. (As the Court of Appeals put it, “Hemingway wasted little time in breaching the contract.”) The trial court rejected Hemingway’s argument that “she was merely Scott’s live-in housekeeper, she was not sexually intimate with him, and “cheating” probably referred to a potential lawsuit involving Walmart.” That being a factual argument and not the sort of thing that a Court of Appeals usually reverses a trial court for, Hemingway advanced the legal arguments that: a) the contract “merged” with the deed upon execution and, therefore, the fidelity requirement (which wasn’t in the deed) was nullified; and b) that the contract was “unenforceable as against public policy prohibiting contracts in consideration of meretricious sexual services.”

The Court of Appeals rejected both arguments.

The Indiana Court of Appeals decided the case of Brown v. State which involved a resident’s use of force against the police and IC 35-41-3-2 which authorizes such use of force under certain circumstances. The defendant had threatened his neighbors and, when the police went to the defendant’s house, he wouldn’t show his hands through the screen door. The police entered and use force to subdue him, and he resisted. The question was whether the defendant’s use of force was permitted under IC 35-41-3-2. If so, he should not have been convicted of battering a public safety officer.

I was very critical of the legislature’s adoption of the statute, and I think the Court of Appeals reached a just result here. But, I’m not entirely sure that the Court of Appeals reached the correct legal result. (I hasten to add that I am not privy to how the cases were briefed or anything about the case other than the opinion — so it may be that some of that background would change my mind.)

The background is that the Defendant, Brown, was staring down his neighbors who were picking up trash in their back yard, across the alley from him. They got creeped out by his surveillance and asked him what their problem was. Heated words got exchanged. Brown challenged his neighbors to come across the alley and, if they did, he’d “blow their brains out.” The neighbors called the police. The police talked with the neighbors, then went across the street to talk to Brown. They knocked on his door.

Brown opened the front door, holding open the storm door with his left hand while resting his right behind the door jamb, out of the Officers’ view.
“What do you have behind your back there, sir?” asked Spradling.
“Nothing,” Brown replied.
“It’s lying on the counter right now and it’s a .357”—a popular caliber of handgun.
“Why don’t you show me your hands,” said Huth, nearly before Brown had finished his sentence.
Brown, without complying, began to reply, but Huth immediately interrupted him, his voice rising: “Hands up! Hands up! Hands up!”
“My hands are quite visible,” Brown insisted.
The Officers concluded that, by his refusal to show his right hand, Brown had criminally resisted law enforcement. Intending to arrest Brown for that offense but worried that he might draw a gun from his still hidden right hand, Huth drew his stun gun and fired. Seven seconds elapsed between Huth’s first command and the first stun gun shot.

(Internal citations omitted).
Brown tried to close the storm door, the officers entered, and a struggle ensued where Brown and the officers did violence to one another.

One defense Brown raised was under IC 35-41-3-2(i)(1)-(2) which the Court of Appeals describes as follows: “By statute, a person is privileged to use reasonable force if he reasonably believes that the force is necessary to protect himself from the imminent use of unlawful force by police, prevent unlawful entry of his home by police, or terminate unlawful entry of his home by police.”

The trial court had found that the entry by the police was unlawful, but the Court of Appeals disagreed. It looked at a variety of factors and concluded that the entry by the police was lawful. Here’s the problem though — as I noted when I analyzed the statute in 2012 — the statute doesn’t focus on the lawfulness of the police action; it focuses on the reasonableness of a citizen’s belief concerning whether the action is unlawful. It says that the citizen can resist based on a reasonable belief that an unlawful use of force is imminent.

A person is justified in using reasonable force against a public servant if the person reasonably believes the force is necessary to . . . protect the person or a third person from what the person reasonably believes to be the imminent use of unlawful force.

In this case, the trial court believed that the police officers’ entry into the house immediately before using force was unlawful. If the trial court came to that conclusion, it seems difficult to argue that Brown’s belief (correct or incorrect) with respect to the lawfulness of the officers’ entry was unreasonable.

I’m not condoning Brown’s actions or criticizing the officers’ actions. I think the statute was poorly written, and now I think the Court of Appeals may have simply ignored the problematic language in the statute.

On October 21, 2016, the Indiana Supreme Court issued a decision in Patchett v. Lee that reaffirmed and somewhat extended the decision it made in Stanley v. Walker. The general rule in civil litigation is that, when a person has been injured through the negligence of another person, the injured party should receive an amount of money that “makes them whole.” It’s not precise, and often it’s something of a fiction, but the idea is that you ask how many dollars it would be worth for a person to never have been injured in the first place and then require the defendant to pay that much money. When the injury required medical treatment, the defendant is obligated to pay the “reasonable value” of the medical treatment. If you’ve ever wrestled with medical providers or insurance companies, you know that determining the actual value of a medical procedure can be a wildly speculative undertaking.

Back in 2009, defendants were at a disadvantage trying to prove “reasonable value.” One rule of evidence said that medical bills were prima facie evidence of the reasonable value. On the one hand, requiring plaintiffs to do anything else would be probably unfairly burdensome. On the other hand, there’s rarely anything reasonable about the sticker price for medical services. Hospitals have a charge master that forms the starting point for negotiations with insurance companies and government programs. That’s the number that gets spit out by the medical provider’s computers in the initial billing. It often has only a nodding acquaintance with the amount the provider actually expects to get paid for the service. Before Stanley, defendants were often hamstrung in their ability to present evidence of the actual value of the service by courts’ interpretation of the collateral-source doctrine. This was beneficial to Plaintiffs inasmuch as they could get the jury to award the full sticker price, repay the plaintiff’s medical insurer only the amount actually paid, and pocket the difference. The Plaintiff received a windfall depending on how inflated the medical bill was.

As I said back at the time Stanley v. Walker was decided:

There is another statutory rule of evidence known as the collateral source statute that says defendants can’t introduce evidence of, among other things, benefits from insurance paid for by the plaintiff. This makes some sense: why should the guy who hit me get a benefit from the fact that I planned ahead and paid my insurance premiums? But, this collateral source doctrine was used to prohibit introduction of evidence that a medical provider accepted not only payment from an insurance company, but also “wrote off” a chunk of the bill based on its agreement with the insurer. (For it to be a “write off,” one has to start from the premise that the starting price was something other than a fiction in the first place. A dubious proposition.)

So, what the case boils down to, as I read it, is whether the “write off” is properly characterized as a benefit purchased by the plaintiff/insured or as simply a more accurate reflection of what the “reasonable cost” of the service was in the first place. The Supreme Court, in a 3-2 decision, decided that the write-offs could be introduced as evidence of the reasonable value of the medical services — if the hospital agreed to accept the reduced amount as payment in full (regardless of whether the paid portion originated as insurance money or elsewhere), then that is evidence a jury should be able to consider along side the sticker price. The jury can then make its own decision about what the reasonable value is.

In the present case of Patchett v. Lee, the Indiana Supreme Court reaffirmed this approach: Plaintiffs can introduce evidence of the sticker price, Defendants can respond by providing evidence of what providers actually accepted for payment, and the jury can sort it out. The court described this as a middle approach when compared to other states. Some states allow only the billed amounts as evidence. Some states allow only the accepted payment as evidence. Other states, including Indiana, allow both.

The specific wrinkle in this case was whether amounts paid by the Healthy Indiana Plan, a government Medicaid program, represented a negotiated price such that it was actually probative of some sort of market value. The trial court did not think it was and, therefore, excluded evidence of the HIP payments accepted by medical providers as payment-in-full. The Supreme Court disagreed, noting that many providers accepted such payment as payment-in-full; while other providers opted simply not to participate in the HIP program: in other words, participation was not mandatory, and enough providers nevertheless did participate to suggest that the amounts paid were at least somewhat reliable proof of the actual market value of the services.

The Court of Appeals decided Henriquez v. State (h/t Indiana Law Blog). One issue was the language of IC 35-38-1-1(b) which provides:

When the court pronounces the sentence, the court shall advise the person that the person is sentenced for not less than the earliest release date and for not more than the maximum possible release date.

Instead of telling Henriquez his earliest release date and the latest release date, the sentencing court told him “he was sentenced for ‘not less than the earliest release date
and [] for not more than the maximum possible release date.'” This, of course, provides him with no meaningful information. Nevertheless, two members of the Court of Appeals decided this was acceptable because not being informed of the actual dates did not actually harm Henriquez and because it would be “incredibly difficult” for the trial court to interpret the actual dates. Figuring out sentencing times can be very complex.

The trial court would have to consider not only the term of the sentence but also the term of any other concurrent or consecutive sentence, credit time earned before sentencing, the maximum amount of credit time in the current credit class, possible educational credit time, and the possibility of parole and probation violations and revocations down the road.

The Court urged the General Assembly to reconsider the statute and the “unworkable obligation it places on our trial courts.”

I was just thinking of how much I would not want to represent a jailer if, having been told by a court to advise a prisoner of his maximum possible release date, the jailer decided it would be too hard to calculate and just told the prisoner, “the court wanted me to tell you that you would not be held past your maximum possible release date.” If we went to the judge and told the judge that the jailer offered no meaningful information to the inmate because figuring out the maximum release date would have been too complicated, my guess is that the judge would not be amused.

Judge Baker (the third member of the panel), for his part, dissented. He was willing to accept that the task mandated by the General Assembly was difficult but disagreed that it could, therefore, be ignored entirely.

[I] do believe that the clear statutory language requires the trial court to attempt to calculate the earliest date a defendant could be released and also the outside limit of the
possible actual time of incarceration. The mere fact that a statutory requirement is difficult to fulfill cannot possibly mean that it can be ignored altogether.

On March 14, 2016, the Indiana Court of Appeals decided the case of Parkview Hospital v. Frost. (Parkview seems to make a lot of case law on the subject of hospital liens.) The question was the proper amount of the hospital lien against the proceeds of an injured party’s personal injury suit. Parkview asserted a lien based on the sticker prices for medical services found in its chargemaster. Frost wanted evidence from Parkview about what it accepted as payment in full for similar procedures from people covered by private insurance or government programs. Parkview declined to provide that information and asked the court to determine that its chargemaster rates were owed as a matter of law. The trial court declined to make that finding. Two members of the Court of Appeals panel agreed and said that Frost should be able to discover information about what other patients paid and introduce that to challenge the lien amounts.

Judge Najam, however, said that — while he agreed this would be a reasonable decision in a vacuum — it ignored the Supreme Court’s ruling in Allen v. Clarian Health Partners. The Supreme Court in that case had overruled an opinion written by Judge Najam. Judge Najam argues that Allen stands for the proposition that patients signing an agreement to pay for medical services are, in fact, agreeing to pay the chargemaster rates regardless of whether those rates are reasonable, rational, or known to the patient. He feels bound by Allen but disagrees with it and urges the Supreme Court to revisit its holding:

Thus, in its operation and effect, Allen places health care consumers, including emergency room patients, at a permanent, take-it-or-leave-it disadvantage. Allen immunizes a hospital’s unilateral pricing scheme from an evaluation or comparison by individual consumers or the marketplace at the front-end and then leaves those same consumers without recourse from a trier of fact at the back-end. Given that there is no price transparency, to insinuate chargemaster rates into an agreement “to pay the account” cannot possibly represent a meeting of the minds between the contracting parties. Chargemaster rates are not per se reasonable when they are, first, confidential and, second, incomprehensible. In sum, there is no discernable or reliable correlation between chargemaster rates and the reasonable value of the health care services provided.

(As is probably evident from my prior blog posts linked above), I tend to agree with Judge Najam. We need more consistency on standards of proof and whether a reasonableness standard applies where there is no prior meeting of the minds as to health care charges. At the moment, there seems to be a lot of variability based on who is paying and not so much based on what services were provided and the reasonable costs/prices of those services.